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Table 4 What are the most important outcomes? Case example: The licensing of tobacco retailers

From: SUPPORT Tools for evidence-informed health Policymaking (STP) 16: Using research evidence in balancing the pros and cons of policies

The primary outcome considered by the expert report commissioned by the government concerned was the prevalence of smoking. This was recognised to be a surrogate outcome for the consequences of smoking. The impact on life years saved was estimated based on the estimated impact on the prevalence of smoking and on epidemiological data linking smoking to mortality. Impacts on morbidity were not considered. Other impacts that were explicitly considered by the experts were administrative costs, political acceptability and public acceptability. There are a number of other outcomes that the expert report could have considered, including:
• Costs to retailers and potential harms (e.g. increased theft or cross-border shopping)
• Who would pay the administrative costs of such schemes
• The potential differences in the impacts of the policy on different populations (e.g. socio-economically disadvantaged minors or those living close to the country's border (who could potentially cross over into a neighbouring country to purchase tobacco)
• Ethical consequences (e.g. those related to the use of a minor or person pretending to be a minor for compliance checks, or the fairness of the policy in relation to the potentially different impacts on different groups of minors and different retailers)